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#FaceFacts – Atopic Dermatitis

Atopic dermatitis (AD) is a chronic skin condition characterized by dry, itchy skin. AD is often referred to as eczema, a word that refers to a broader group of skin conditions. "Dermatitis" refers to a condition of the skin and "atopic" relates to diseases caused by allergic reactions.

As an atopic disease, AD is in the same classification as hay fever and asthma.

What are the types of atopic dermatitis?

All types of eczema cause itching and redness, but AD is the most severe and chronic type of eczema. Other types of eczema include:

  • hand eczema

  • contact dermatitis, which occurs only when the skin makes contact with certain substances

  • dyshidrotic eczema, a blistering form of eczema that’s found only on the fingers, palms, and soles of the feet

Doctors and researchers are working to better understand how eczema works and why it affects so many people. There’s currently no known cure for this common disease.

What are the symptoms of atopic dermatitis?

The primary symptom of AD is dry, itchy skin that often turns into a red rash. During a flare, AD becomes a red, itchy rash. Many different physical and internal factors can trigger an eczema flare-up. The resulting inflammation causes increased blood flow and the urge to itch. Eczema flares are part of the agonizing itch-scratch cycle. It’s hard to fight the physical and psychological components that drive the itch-scratch cycle. Scratching feels good at the time but can lead to more inflammation and even skin infections.

Symptoms in infants can include:

  • dry, itchy, scaly skin

  • a rash on the scalp or cheeks

  • a rash that may bubble and weep clear fluid

Infants with these symptoms may have trouble sleeping due to itchy skin. Infants with AD may also develop skin infections from scratching.

Symptoms in children can include:

  • a rash in the creases of the elbows, knees, or both

  • scaly patches of skin at the site of the rash

  • lightened or darkened skin spots

  • thick, leathery skin

  • extremely dry and scaly skin

  • rashes on the neck and face, especially around the eyes

Symptoms in adults can include:

  • Adults who had AD as children may have discolored skin that is easily irritated.

About 17.8 million people have AD. The basic understanding of AD is that inflammation results from the presence of too many inflammatory cells in the skin. There’s also evidence that people with AD have a compromised skin barrier compared to normal skin.

Because of the altered skin barrier, people with AD have drier skin. AD skin is more prone to water loss and the entry of irritants. This all leads to the development of red, itchy rashes.

You’ll need to learn what triggers your AD flare-ups, but common lifestyle and environmental triggers include:

  • long, hot showers or baths

  • scratching

  • sweat

  • heat

  • cold, dry weather

  • soaps, detergents, and cleaners

  • wool and synthetic fabrics

  • physical irritants (dirt, sand, smoke)

  • allergens (pollen, dander, dust)

  • strenuous exercise

  • stress

There’s no known cure for AD. Finding the right treatment is important to help reduce itching and discomfort. Calming the skin reduces stress and helps prevent excessive scratching that leads to skin infections. Treatment options vary from over-the-counter skin care, prescription medication, and lifestyle changes.

The best preventive measure is to moisturize the skin. This improves the function of the skin barrier. Healthier skin will become inflamed less often and provide a better barrier against allergens and irritants.

Bathing and moisturizing each day is the simplest way to hydrate your skin. It’s important to apply a moisturizer within minutes of bathing.

You should see your primary care physician or a dermatologist to receive your initial diagnosis. A doctor can help you create an effective treatment plan and help you understand your triggers.

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